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Illustration by Sissy Hwang and Yoon Do
Current hospital-based studies suggest that the development of new radiotherapy techniques has improved the prognosis of NPC, but population-based research on survival for this cancer is lacking. We also know very little about potential environmental prognostic factors for NPC, such as body mass index (BMI) and body shape, Epstein-Barr virus DNA, and the oral microbiome. So he wanted a PhD student liberate you in Department of Medical Epidemiology and Biostatistics Study population-based survival patterns of patients with NPC and also identify potential predictive factors for NPC disease in southern China.
What are the main findings of your thesis?
Using a population of patients from the so-called NPCGEE project in southern China, we were able to estimate 5-year survival figures and investigate predictive factors related to the environment. We also found population-based survival in NPC to be lower than survival in large hospital-based studies. Being overweight at diagnosis indicated a favorable long-term prognosis, whereas a slimmer body shape at diagnosis was associated with a poorer prognosis. High amounts of Epstein-Barr virus DNA appeared to be a strong predictive factor for NPC and decreased diversity in the oral microbiome was associated with increased mortality. Overall, this is the first population-based prognosis study in NPC in southern China with an almost complete follow-up, and our results point to potential avenues for improving disease management in an area where the disease is endemic.
Are your results generally correct?
– My studies were conducted in an area with a high percentage of NPC where most cases were recruited during the study period. Therefore, our results have high validity and may be applied to a larger population in southern China or other regions with high prevalence.
In your opinion, what should be done for patients in the future?
– We found that nearly a fifth of deaths in NPC could have been avoided if patients had been diagnosed at an early stage. This really motivates me to continue working on NPC early detection methods. It is also important to establish reasonable clinical practice to incorporate nutritional management and plasma levels of EBV DNA into the management of patients with the disease. In terms of future research on the microbiome, there is much that could be investigated, for example the underlying mechanisms or the role of immunity and immunotherapy.
thesis
liberate you. Karolinska Institutet (2023), ISBN: 978-91-8017-044-4
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